| National Provider Identifier [NPI]: | 1710967096 |
| Last Name Of The Provider | BLITZ |
| First Name Of The Provider | PHILIP |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20006 DETROIT RD |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | ROCKY RIVER |
| Zip Code Of The Provider | 441162406 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 2765 |
| Number Of Medicare Beneficiaries | 1788 |
| Total Submitted Charge Amount | 116771.96 |
| Total Medicare Allowed Amount | 67323.38 |
| Total Medicare Payment Amount | 48089.69 |
| Total Medicare Standardized Payment Amount | 50109.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 139 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 4344 |
| Total Drug Medicare AllowedAmount | 1658.37 |
| Total Drug Medicare PaymentAmount | 1524.09 |
| Total Drug Medicare Standardized Payment Amount | 1524.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 2626 |
| Number Of Medicare Beneficiaries With Medical Services | 1788 |
| Total Medical Submitted Charge Amount | 112427.96 |
| Total Medical Medicare Allowed Amount | 65665.01 |
| Total Medical Medicare Payment Amount | 46565.6 |
| Total Medical Medicare Standardized Payment Amount | 48585.89 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 273 |
| Number Of Beneficiaries Age 65 to 74 | 610 |
| Number Of Beneficiaries Age 75 to 84 | 518 |
| Number Of Beneficiaries Age Greater 84 | 387 |
| Number Of Female Beneficiaries | 1021 |
| Number Of Male Beneficiaries | 767 |
| Number Of Non Hispanic White Beneficiaries | 1654 |
| Number Of Black or African American Beneficiaries | 54 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1440 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 348 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.7493 |